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Biomedical subjects

J Bamford

Publications and source records attributed to J Bamford.

69 records · Page 4Linked to original sources
PubMed1988

A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981-86. 1. Methodology, demography and incident cases of first-ever stroke.

A prospective study of acute cerebrovascular disease in a community of about 105,000 people is reported. The study protocol combined rapid clinical assessment of patients with accurate diagnosis of the pathological type of stroke by CT or necropsy, whether or not they were admitted to hospital. The study population was defined as those people who were registered with one of 50 collaborating general practitioners (GPs). Referrals to the study were primarily from the GPs though, to ensure complete case ascertainment, hospital casualty and admission registers, death certificates and special data from the Oxford Record Linkage Study were also scrutinized. Six hundred and seventy five cases of clinically definite first-ever in a lifetime stroke were registered in four years yielding a crude annual incidence of 1.60/1,000 or 2.00/1,000 when adjusted to the 1981 population of England and Wales. The age and sex specific incidence rates for first stroke showed a steep rise with age for both sexes. The odds of a male sustaining a first stroke were 26% greater than those of a female. Ninety one per cent of patients were examined in a median time of four days after the event by a study neurologist and 88% had cerebral CT or necropsy.

Adolescent↗
PubMed1986

Why are patients with acute stroke admitted to hospital?

Data on 515 consecutive patients registered with the Oxfordshire Community Stroke Project were used to compare the characteristics of those patients who were admitted to hospital within one month after their first stroke with those who remained in the community during that time. Twenty eight patients had their stroke while in hospital for other conditions, and of the remaining 487, 266 were admitted. Though patients with a severe neurological deficit were significantly more likely to be admitted, 47 out of 202 such patients were managed in the community. In a substudy of 162 consecutive patients the general practitioners' reasons for either arranging admission to hospital or continuing with community care in the first week after the stroke were ascertained. Sixty patients were admitted. The only reason for admission was diagnostic uncertainty in five cases (though this was a contributing factor in 25) and to provide nursing or general, non-medical care in 25. Patients who lived alone were more likely to be admitted. All 12 patients who presented directly to the casualty department were admitted, though only five had had a severe stroke. A stroke service that provides a facility for rapid outpatient and domiciliary diagnosis as well as a rapidly acting domiciliary nursing team might reduce the number of patients with stroke admitted to hospital without adversely affecting the quality of patient care: this should be properly evaluated.

Acute Disease↗
PubMed1986

Is a controlled trial of long-term oral anticoagulants in patients with stroke and non-rheumatic atrial fibrillation worthwhile?

A controlled randomised trial large enough to assess the value of anticoagulating stroke patients in atrial fibrillation would be difficult to conduct in the UK and the results would be applicable to only a small proportion of stroke patients. It would be more worthwhile to organise a trial that also assessed the value of other treatments that are simpler and applicable to all stroke patients. A trial that assessed the value of aspirin and beta-blockers against control in all stroke patients would not cost much more than one restricted to comparing anticoagulants against control in patients with stroke and atrial fibrillation but would provide information of more relevance to the management of patients with stroke in the UK.

Administration, Oral↗
PubMed1986

Late rupture of a mycotic aneurysm after "cure" of bacterial endocarditis.

Rupture of a mycotic aneurysm often occurs before the diagnosis of bacterial endocarditis is made or whilst the patient is being treated with antibiotics. It is recognised that cerebral embolism continues to occur after adequate antibiotic treatment, but the late rupture of a mycotic aneurysm seems to be very unusual. We report such a case where rupture of a peripherally sited aneurysm, demonstrated angiographically and pathologically, occurred 6 months after bacteriologically adequate treatment of streptococcal bacterial endocarditis.

Aneurysm, Infected↗
PubMed1979

The BKB (Bamford-Kowal-Bench) sentence lists for partially-hearing children.

Linguistic guidelines for the design of sentences for speech audiometry with children are described, and new lists of test sentences which are based on such guidelines--the Bamford-Kowal-Bench Sentence Lists for Children--are introduced. Audiometric data relating to the use of the new lists are presented and discussed.

Adolescent↗
PubMedDate not supplied

The natural history of lacunar infarction: the Oxfordshire Community Stroke Project.

In a consecutive series of 515 first-ever strokes in a community-based study of stroke that combined prompt clinical assessment by a study neurologist with a high rate of confirmed pathologic diagnosis, 108 cases (21%) had a lacunar syndrome. A computed tomography (CT) scan was performed in 104 (96%) of these cases. Only 3 cases had primary intracerebral hemorrhage, and another 3 had "inappropriate" areas of infarcts were seen in 34 of the remaining 98 (35%) CT scans. The crude annual incidence of lacunar infarction was 0.33/1,000. There was no excess risk among men. The case fatality rates were 1% at 1 month and 9.8% at 1 year. The rate of recurrent strokes was 11.8% in the first year. Among patients surviving 1 year, 66% were capable of independent existence.

Activities of Daily Living↗
PubMedDate not supplied

Remedial therapy and functional recovery in a total population of first-stroke patients.

A consecutive series of 155 patients with a first-ever stroke and who were registered with the Oxfordshire Community Stroke Project (OCSP) were followed up. Their receipt of remedial therapy was recorded and their functional recovery was measured using the Barthel index of activities of daily living. Only a minority of patients received remedial therapy during the first 6 months after stroke. Those who were admitted to hospital during the first month following their stroke, or who were severely dependent, were significantly more likely to receive remedial therapy than those who remained in the community or were less dependent. A comparison of functional recovery amongst a matched subsample of patients who received remedial therapy and those who did not showed that there was comparable recovery amongst patients who did not receive remedial therapy.

Activities of Daily Living↗
PubMedDate not supplied

Prevalence and age of identification of permanent childhood hearing impairment in Cyprus.

Permanent childhood hearing impairment is a significant public health issue in the United Kingdom and elsewhere. It has effects on the hearing-impaired individual's linguistic, psychological, educational, and vocational development. Data on prevalence are an essential prerequisite for efficient service planning and development. This paper reports the first study to be undertaken in Cyprus to investigate the prevalence and the age at identification of permanent bilateral (congenital or acquired/late-onset) childhood hearing impairment of 50 dB HL or greater. The study was based upon a case ascertainment approach for children born between 1979 and 1996. Two methods were employed for the data collection: interrogation of case records and questionnaires administered to parents. The results for those years in which most cases are likely to have been identified showed an estimated prevalence of 1.19/1,000 live births (congenital) and 0.40/1,000 live births (acquired/late onset), with a mean identification age of 44.0 months for congenital cases. These findings are discussed with reference to the service development needs in Cyprus.

Adolescent↗